What to do when allergy medicine doesn t work

I’ve tried it all: Zyrtec, Allegra, Claritin, Xyzal, Benadryl, Nasacort, Flonase—even a neti pot—and still, I struggle to find one single, effective tool that’ll rid my bloodshot eyes and mucus-lined nose once and for all.

• Off
• English

According to Dr. David Erstein, an allergist at Allergy and Asthma Wellness, Advanced Dermatology, and NYC HHC, if you, too, are struggling to find which allergy medicine works best for you, sometimes, all it takes is a combination of different drug types (and never leaving your home) to battle the nightmare of seasonal allergies.

You might develop a tolerance to drugs, but there are also a number of other factors

First, you’ll need to know a little bit about the allergy medications you’re likely taking. The two most common drug types you’ll find over the counter are antihistamines and steroidal nasal sprays.

Antihistamines work by blocking histamine, a chemical which causes your immune system to overreact to “threats” like pollen. Drugs like Claritin are considered “second-generation” antihistamines, as they don’t result in side-effects like drowsiness you might find with “first-generation” meds like Benadryl. (You might prefer the former for this reason.)

Steroidal nasal sprays (like Flonase) help curb your allergies by telling your nasal passages to stop making proteins like histamines and start making ones that suppress your allergic responses, Iodine writes; Erstein said these sprays are generally more effective than your usual antihistamine. (There are a number of other prescription medications, too, you can get from a doctor like “beta-agonist” inhalers).

G/O Media may get a commission

15% off

ASYSTEM - Pre-Workout+

Bruce Wayne-inspired
Pre-Workout gives enhanced energy and better recovery for your long workouts, with InnovaTea and Tibetan Cordyceps to fuel you.

Use the promo code INVENTORY15

According to Erstein, it’s entirely possible to develop a tolerance to either medication, so the Zyrtec you’ve been using daily may feel like it’s losing effectiveness over time. Research into allergy medication tolerance is sparse, but there are number of other explanations to consider, too.

Weather is a huge factor in seasonal allergies: dry, windy weather distributes allergens like pollen more easily, whereas a rainy day can actually reduce pollen count, which may explain why you’re feeling especially terrible right now. (Air pollution, too, has been shown to worsen allergic reactions and tends to spike during summers.) Annoyingly, allergies might actually get worse with age, too, and stress might play a role in why you’re sneezing more today than usual. Of course, everyone also reacts to allergy medications differently, so any number of these factors may result in a day full of sneezing.

Combine antihistamines with a steroid spray

According to Erstein, the first-line in tackling seasonal allergies, in general, is using a steroidal nasal spray with an oral antihistamine. If an antihistamine like Zyrtec suddenly feels as though it’s not working (like your eyes are red or mucus is everywhere), you’re okay to switch to another antihistamine like Allegra to try it out; switching back is okay, too, Erstein said.

You can also supplement both with a general saline nasal spray to rinse out your nose. You could also use a decongestant nasal spray, which shrinks blood vessels in the nose for short-term congestion relief, though Erstein cautions against using these long-term, too—especially in the case of the spray, Afrin. “If you use it more than a few days, you can have something called ‘rebound rhinitis,’” he said. “It helps you, and then all of a sudden, your congestion comes back and quicker.”

The best prep, however, should come weeks in advance of allergy season, he added. “I typically tell people to use things like steroid sprays a couple of weeks before the season starts, so you’re not as bombarded. The issue with steroid nasal sprays is that they don’t work that quickly. If you’re in the midst of [an allergy] season, the problem with the [nose’s] anatomy is that it’s all inflamed with irritants. Even if you’re using the nasal steroid spray, you’re playing catch-up.”

You can relieve allergies through some behavioral changes

And if allergy meds fail, there are still a few things you can do for relief. Perhaps the most obvious—staying indoors—is pretty key, especially if you have something like pollen allergies. “Limiting your exposure to these things that you’re allergic to will help,” he said. “These pollen travel for miles [and] will stick on you, so when you come home from outside, it’s important to change before you go to sleep.”

If you can’t stay inside all day like a hermit, Erstein also recommends, at the very least, keeping windows closed in the mornings, when the pollen count is generally at its highest, and changing your filter out in your air conditioner regularly, so it’ll help trap some of your allergens. And if you’re in dire straits, Erstein also recommends allergy immunotherapy, which involves several shots taken over years but still isn’t fool-proof—so consult with your doctor if it sounds like a gamble you’re willing to take.

For more from Lifehacker, be sure to follow us on Instagram @lifehackerdotcom.

Can I take two allergy pills if one isn't working?

How come my allergies won't go away?